| NPI | 1588068464 |
|---|---|
| Former Name | REBECCA HARRISTHAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2021003533) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209012066) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: IL 309.007726) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 309.007726) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2017035715) | |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2024-08-29 |