NPI | 1770995508 |
---|---|
Former Name | MICHELLE MARTINE CLARKES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.15910) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.15910) |
Enumeration Date | 2014-05-28 |
Last Update Date | 2023-02-05 |