| NPI | 1083116107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY C LU Credentialing Manager 904-221-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP9239957) |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2018-03-05 |