| NPI | 1104622893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY MCCRUDDEN Nurse Practitioner / Owner 708-232-8854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2025-02-22 |
| Last Update Date | 2025-05-28 |