| NPI | 1063866945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERLANDE PENN DURANDISSE Owner 347-489-9954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2024-05-07 |