| NPI | 1356982797 |
|---|---|
| Former Name | JACQUELINE LEEANN THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: NC 5012379) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5012379) |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2021-05-04 |