| NPI | 1548346026 |
|---|---|
| Former Name | CAROL MARY VANDENBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP30003275) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA RN00046264) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2012-07-25 |