| NPI | 1043928369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE ANN OWENS Psychiatric Nurse Practitioner 339-499-8753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2022-11-07 |