| NPI | 1083180129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.025578) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 339820) |
| Enumeration Date | 2018-10-16 |
| Last Update Date | 2021-10-07 |