| NPI | 1164265682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE OKONIGBO Np 240-702-3574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2025-04-25 |