| NPI | 1245969492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN-109523) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OH RBT-22-205641) |
| Enumeration Date | 2022-06-05 |
| Last Update Date | 2022-06-05 |