| NPI | 1386300739 |
|---|---|
| Former Name | TAMARA L DIVINO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202200877NP-PP) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP61217138) |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2024-04-16 |