| NPI | 1154012391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY OLORUNSOLA Owner 623-203-6183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-05-18 |
| Last Update Date | 2023-05-18 |