NPI | 1073204467 |
---|---|
Entity Type | Organization |
Authorized Contact | GINA SUZANNE BALLARD-SCHMUNK Owner 218-368-2313 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2023-05-16 |
Last Update Date | 2024-03-07 |