| NPI | 1053879775 |
|---|---|
| Doing Business As | IWAMH |
| Entity Type | Organization |
| Authorized Contact | ZACHARIAH HODGSON Owner/Administrator 479-469-0313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2020-08-11 |