| NPI | 1841836244 |
|---|---|
| Other Name | MARY JO TICHACEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95024198) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 202048) |
| 364S00000X Clinical Nurse Specialist (Licence: CA 207) | |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2025-10-29 |