| NPI | 1497238299 |
|---|---|
| Former Name | TASHA CHARLENE LEIBENSPERGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: PA SP019222) |
| Enumeration Date | 2018-09-08 |
| Last Update Date | 2018-09-08 |