| NPI | 1770174179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0039749) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 395129) |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2026-01-12 |