| NPI | 1952968398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH PN156449) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH PN156449) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2019-05-21 |