| NPI | 1750705513 |
|---|---|
| Former Name | STACEY DANIELLE OGLETREE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AR A005293) |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2023-09-28 |