| NPI | 1558694240 |
|---|---|
| Former Name | LARISSA JEAN REAVES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN116195) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: OH PN116195) |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2016-05-20 |