| NPI | 1053028969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0032555) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.0006818-SUPV) |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2022-10-31 |