| NPI | 1902413677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH APRN.CNP.0039643) |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH RN412520) |
| 163W00000X Registered Nurse (Licence: OH RN.412510) | |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2025-11-19 |