NPI | 1144736935 |
---|---|
Former Name | DEBORAH LYNN MYNCHENBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 1003046) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 022380) |
364SA2200X Clinical Nurse Specialist, Adult Health (Licence: OH APRN.CNS.09180) | |
Enumeration Date | 2017-12-16 |
Last Update Date | 2021-12-14 |