| NPI | 1316604648 |
|---|---|
| Former Name | MIRANDA THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0037876) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OH 408222) |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2026-01-06 |