| NPI | 1245052612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH RN.522217) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LPN.170690.MEDS-IV) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OH 2024) | |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2025-01-14 |