| NPI | 1073024386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY EDVALINE VANSIEA CEO & Founder, Cch 651-460-0193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F4018161) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 4951221) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2020-03-24 |