| NPI | 1154944536 |
|---|---|
| Doing Business As | FUNCTIONAL MENTAL HEALTH LLC |
| Entity Type | Organization |
| Authorized Contact | MCKENZIE SMITH Pmhnp 541-326-8078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2021-01-27 |