| NPI | 1366731739 |
|---|---|
| Former Name | HOLLY SUE MATA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: AZ RN147845) |
| Additional Taxonomies | 163WR0400X Registered Nurse Rehabilitation (Licence: PA TLRN035206) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2024-09-06 |