| NPI | 1790246742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.103346.MEDS) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 001190) |
| Enumeration Date | 2019-03-30 |
| Last Update Date | 2024-02-12 |