| NPI | 1417793639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMESHIA WIGGINS Pmhnp 419-208-9121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| 363LA2200X Nurse Practitioner Adult Health | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2024-07-08 |