NPI | 1962246850 |
---|---|
Former Name | TRACY MOSES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11033468) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11033468) |
Enumeration Date | 2024-06-24 |
Last Update Date | 2025-02-17 |