| NPI | 1063395358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0039874) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.430329) |
| Enumeration Date | 2025-07-26 |
| Last Update Date | 2025-11-18 |