| NPI | 1568851509 |
|---|---|
| Former Name | MIRANDA LEE HENNES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA Ap60494711) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2025-02-04 |