| NPI | 1427399377 |
|---|---|
| Former Name | RAEQUEL ALLYSSA FORBES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP032464) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW017538) |
| Enumeration Date | 2013-03-01 |
| Last Update Date | 2025-09-19 |