Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | ||
Y | 175L00000X | Homeopath |
NPI | 1477167674 |
---|---|
Provider Name | Jessica A Buttari |
First Address | Mentor, OH 44060-6517 |
Second Address | Mentor, OH 44060-6517 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2020 |
Last Update Date | 04/09/2020 |