| NPI | 1750074613 |
|---|---|
| Former Name | ELIZABETH VALLEJOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11025761) |
| Enumeration Date | 2023-05-29 |
| Last Update Date | 2025-06-12 |