| NPI | 1669893632 |
|---|---|
| Former Name | CAMILLE COBURN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NC 257107) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041394483) |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2013-12-18 |