NPI | 1467235051 |
---|---|
Former Name | KATHLEEN CHANEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: IL 209028104) |
Enumeration Date | 2023-08-16 |
Last Update Date | 2024-09-18 |