| NPI | 1548095185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 175208.MEDS-IV) |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2024-09-05 |