| NPI | 1922068022 |
|---|---|
| Former Name | CONSTANCE SUE LACKNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 7278) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024182053) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2024-11-06 |