| NPI | 1730669086 |
|---|---|
| Former Name | TYLON BOGGS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0036302) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 119926) |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2024-06-14 |