| NPI | 1124717103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALENA MARIE DEBROSSE Owner 516-312-9486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-05-04 |
| Last Update Date | 2023-05-04 |