| NPI | 1649919994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4002129) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OH 304490) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 0032284) | |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2023-05-18 |