| NPI | 1497158521 |
|---|---|
| Former Name | HEATHER SUSIE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 005919) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 5919) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2023-08-15 |