NPI | 1013548981 |
---|---|
Doing Business As | MICGRA PSYCH LLC |
Entity Type | Organization |
Authorized Contact | ODETTE AMANDA BUTLER Owner 404-751-3700 |
Organization Subpart ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2020-01-30 |
Last Update Date | 2023-11-15 |