Individual
KATRIENA KALAILA VAN DE VELDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
95030130
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D8683328
DRIVERS LICENSE
CA
Enumeration date
11/05/2019
Last updated
11/05/2019
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