NPI | 1417484254 |
---|---|
Former Name | SUSANNA DRAINE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2327944) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: RI APRN01685) |
Enumeration Date | 2017-05-11 |
Last Update Date | 2024-08-13 |