| NPI | 1366723579 |
|---|---|
| Former Name | BRENDA DELORES WHITAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: DE L80010523) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: DE L80010523) |
| 163W00000X Registered Nurse (Licence: DE L10072744) | |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2024-06-03 |