| NPI | 1154887529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA TUMANENG Assistant Manager/Billing 850-243-7035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2019-02-11 |