| NPI | 1134785041 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | LABAKE OGUNNUPE Pmhnp Bc 202-276-9353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2022-06-17 |