| NPI | 1467178244 |
|---|---|
| Former Name | MACENSIE LEIGH GOODWIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: LA 229361) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: LA R-11388) |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2025-05-05 |