| NPI | 1497372734 |
|---|---|
| Former Name | COURTNEY SLADE HANNON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024179610) |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2022-01-17 |