| NPI | 1003614645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA M HOUSE Owner And Primary Provider 904-525-0896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-03-07 |
| Last Update Date | 2025-03-07 |