| NPI | 1871815712 |
|---|---|
| Former Name | ELIZABETH ANNE PEABODY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704211535) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MI 4704211535) |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2010-09-02 |