| NPI | 1063360170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.167318.MEDS-IV) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2026-03-17 |
| Last Update Date | 2026-03-17 |