| NPI | 1407476963 |
|---|---|
| Former Name | STACY KATHY TSIKLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MA RN2279636) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2279636) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2020-04-24 |