NPI | 1134723794 |
---|---|
Entity Type | Organization |
Authorized Contact | ARLETTE OWENS-MOSLEY Provider 980-207-1003 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
261QP2300X Clinic/Center, Primary Care | |
363LP2300X Nurse Practitioner, Primary Care | |
Enumeration Date | 2020-11-24 |
Last Update Date | 2023-10-30 |