NPI | 1487172524 |
---|---|
Former Name | CORINNA MICHELLE EDWARDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 12.008313) |
Enumeration Date | 2017-09-08 |
Last Update Date | 2019-09-10 |