| NPI | 1124883400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.146569.MEDS-IV) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 186841) |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2025-08-05 |