| NPI | 1790183549 |
|---|---|
| Former Name | PAULA SUSAN TAKACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NM CNP02875) |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2019-10-18 |