| NPI | 1043942899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELISHA MACK Pmhnp Bc, Fnp Bc 475-298-3887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2022-06-29 |