| NPI | 1053102848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOLULOPE ISINKAYE Manager 307-683-8188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-05-13 |
| Last Update Date | 2025-05-13 |