| NPI | 1255020806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 116820) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0033960) |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2024-07-29 |