| NPI | 1164121315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA MALONE Owner/Authorized Official 734-568-3024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2023-02-27 |