| NPI | 1982454211 |
|---|---|
| Former Name | AMANDA C WOODMANSEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: NY 659066) |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2024-03-27 |