| NPI | 1346838653 |
|---|---|
| Former Name | JACQUELINE TABOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0037566) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.457700) |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2024-09-30 |