NPI | 1497564504 |
---|---|
Former Name | LISA MARIE MANNING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1179320) |
Enumeration Date | 2025-01-03 |
Last Update Date | 2025-01-03 |