NPI | 1699803692 |
---|---|
Former Name | SUSAN MARIE BRILL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.12685) |
Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: OH RN 315915) |
Enumeration Date | 2007-03-01 |
Last Update Date | 2021-02-09 |