| NPI | 1518730449 |
|---|---|
| Former Name | AMY MARLENE HOUSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2023035576) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2019025605) |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2024-06-28 |