| NPI | 1639950843 |
|---|---|
| Former Name | MICHELE PICKERELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA 95027457) |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2023-10-12 |