| NPI | 1689891525 |
|---|---|
| Former Name | THERESA FORREST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: TN RN0000122788) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2007-07-08 |