| NPI | 1841901741 |
|---|---|
| Former Name | AMANDA LENAE BISSONETTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MI 4704381107) |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2022-12-12 |