| NPI | 1083239255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIMI TYSON Psychiatric Nurse Practitioner 301-392-7120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2023-04-20 |