| NPI | 1154295749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERELLE SION PICKNEY Manager 866-670-1923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-10-06 |
| Last Update Date | 2025-12-08 |