| NPI | 1992202659 |
|---|---|
| Former Name | HEATHER REDENA MOSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN3317032) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ARNP3317032) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2023-05-05 |