| NPI | 1114636438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTIQUE CHANTAY HENRY Pmhnp 614-597-2132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2022-11-15 |