| NPI | 1417008384 |
|---|---|
| Former Name | THERESA WINFIELD HICKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP30004371) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: WA RN00045172) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2019-05-01 |