NPI | 1679125363 |
---|---|
Former Name | TAYLOR MARIE BEACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704316158) |
Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MI 4704316158) |
Enumeration Date | 2019-07-12 |
Last Update Date | 2022-05-17 |