| NPI | 1831736826 |
|---|---|
| Former Name | CAROL LORRAINE ELLIOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA 252410) |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2019-12-09 |