| NPI | 1972192243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH LE-00039965) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH RN.343131) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2022-03-09 |