| NPI | 1114720752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY KELLY LABRECQUE Owner 774-238-8783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-03-29 |
| Last Update Date | 2025-03-29 |