| NPI | 1831565829 |
|---|---|
| Former Name | MALLORY ANDREASSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: IA G181636) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IA 092680) |
| 101YP2500X Counselor Professional (Licence: MN CC01021) | |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2025-03-24 |