| NPI | 1144907841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE NICOLE SANDERS Owner/ Provider 121-676-7997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2023-07-03 |