NPI | 1043601685 |
---|---|
Entity Type | Organization |
Authorized Contact | DENISE KNIGHT Credentialing Admin 845-551-9673 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA RN79944 AP3962) |
Enumeration Date | 2015-02-17 |
Last Update Date | 2023-03-07 |