Individual
MISTIQUE CHANTAY HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3820 OLENTANGY RIVER RD, COLUMBUS, OH 43214-5403
(614) 566-4414
Mailing address
3820 OLENTANGY RIVER RD, COLUMBUS, OH 43214-5403
(614) 566-4414
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.025613
OH
Other
Enumeration date
09/16/2019
Last updated
01/25/2022
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