| NPI | 1659666444 |
|---|---|
| Former Name | SHUKAIRO MACK TOWNSEND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5020242) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C008389) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC C008389) | |
| 1041C0700X Social Worker, Clinical (Licence: SC 11094) | |
| 163W00000X Registered Nurse (Licence: SC 268707) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 13998789-4405) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 13998789-8900) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2024-10-31 |