| NPI | 1598493090 |
|---|---|
| Former Name | BREANNA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0033978) |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2023-08-10 |