| NPI | 1619616323 |
|---|---|
| Former Name | HEIDI VANDESLUNT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse Addiction (Substance Use Disorder) (Licence: WI 235370) |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-09-08 |