| NPI | 1497014005 |
|---|---|
| Former Name | JAMIE LEE WADDELOW |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95066330) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA VN263396) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2015-09-03 |