| NPI | 1912712035 |
|---|---|
| Other Name | JEANNIE (AKA) VANDERWEIDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: SD sd-rn-R030001) |
| Enumeration Date | 2025-02-07 |
| Last Update Date | 2025-02-07 |