Organization
TASSIELLIMENTALHEALTHANDWELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIDIA BERRONE APRN, PMHNP-BC (OWNER)
(937) 502-4567
Entity
Organization
Contact information
Practice address
3085 WOODMAN DR STE 205, KETTERING, OH 45420-1171
(937) 502-4567
(609) 293-0270
Mailing address
3085 WOODMAN DR STE 205, KETTERING, OH 45420-1171
(937) 502-4567
(609) 293-0270
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
364SA2100X
Acute Care Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0458021
—
OH
Enumeration date
08/24/2021
Last updated
09/30/2021
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