| NPI | 1760836860 |
|---|---|
| Former Name | SUSAN MARIE SANDERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: KY 1057835) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2016-04-15 |