| NPI | 1821557554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 50.005810RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005810RX) |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2022-12-08 |