| NPI | 1336903053 |
|---|---|
| Former Name | BRENDOLYN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent (Licence: LA RN159030) |
| Enumeration Date | 2024-02-13 |
| Last Update Date | 2024-02-13 |