NPI | 1467712752 |
---|---|
Former Name | SHADETTE DALES OLJOL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95029783) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: CA 95022060) | |
Enumeration Date | 2012-05-21 |
Last Update Date | 2024-05-16 |