| NPI | 1902583917 |
|---|---|
| Former Name | ASHLEY MITCHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 36562) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: TN 180297) |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2024-11-04 |