| NPI | 1427826692 |
|---|---|
| Former Name | LAUREN J PARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 12806) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CT 144761) |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2024-01-25 |