| NPI | 1558752170 | 
|---|---|
| Former Name | MOLLIE MCDANIEL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA AP60782636)  | 
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: WA RN60276437)  | 
| Enumeration Date | 2015-02-18 | 
| Last Update Date | 2021-04-01 |