Individual
ILILLI AMBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6895 E MAIN ST, REYNOLDSBURG, OH 43068-2289
(614) 334-6903
Mailing address
140 E TOWN ST STE 1450, COLUMBUS, OH 43215-6601
(614) 334-6903
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0035536
OH
Other
Enumeration date
02/09/2024
Last updated
05/05/2025
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