| NPI | 1629718440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMBOLDENED WELLNESS THERAPEUTICS Authorized Official 937-204-3505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2022-04-12 |