| NPI | 1528809126 |
|---|---|
| Former Name | ASHLEY LYNN MACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0035953) |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2024-06-09 |