| NPI | 1124918065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN-MARIE FAITH ANTHONY Owner 640-204-5246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-07-03 |
| Last Update Date | 2025-07-03 |