| NPI | 1386384097 |
|---|---|
| Former Name | STEPHANI CHINWENNAJIDEMAOBAME |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1072156) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95032978) |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2025-01-13 |