| NPI | 1932977584 |
|---|---|
| Former Name | STEPHANIE LYNNE MCDONELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404719) |
| Enumeration Date | 2023-12-13 |
| Last Update Date | 2023-12-13 |