| NPI | 1154058790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA POTTER Pmhnp 540-616-2312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2025-03-05 |