| NPI | 1053183228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA NICOLE HANSEN VELA Owner 772-268-7757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2023-10-23 |