| NPI | 1003464512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA MAE CASIANO Owner/Pmhnp Bc 907-707-1201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2020-12-18 |