| NPI | 1326719964 |
|---|---|
| Former Name | JACQUELINE E DODD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2021099690) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2021-12-14 |