NPI | 1376088286 |
---|---|
Former Name | ERICA CHARISSE TULLISON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 374T00000X Religious Nonmedical Nursing Personnel (Licence: TN 140189) |
Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
Enumeration Date | 2017-01-01 |
Last Update Date | 2017-01-01 |