| NPI | 1720828668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.124035.MEDS-IV) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH LPN.124035.MEDS-IV) |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2024-09-23 |