| NPI | 1457733891 |
|---|---|
| Former Name | MACKENZIE TYLER MANCINI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN234199) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN234199) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2020-03-25 |