| NPI | 1083500482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA MUYONGA Owner Of Entity 346-631-5576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-06-13 |
| Last Update Date | 2025-06-13 |