| NPI | 1750071056 |
|---|---|
| Former Name | STEPHANIE MARIE MANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-165097) |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2023-05-10 |