NPI | 1780610170 |
---|---|
Former Name | PAMELA MCCORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R236222) |
Additional Taxonomies | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: RI PPNS00068) |
Enumeration Date | 2006-06-25 |
Last Update Date | 2021-02-03 |