| NPI | 1487313698 |
|---|---|
| Former Name | SHERISSA-NICOLE SEBASTIAN MANGANELLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO 0998119) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95106933) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CO 1644417) | |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2024-02-21 |