| NPI | 1689819864 |
|---|---|
| Former Name | REGINA DAWN PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP117298) |
| Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: TX 693101) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2019-01-28 |