NPI | 1548552904 |
---|---|
Former Name | VIRGINIA CARYL OTTO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO APN0990068-NP) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CO NP990068) |
Enumeration Date | 2011-05-04 |
Last Update Date | 2020-07-24 |