| NPI | 1174146708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LYNN CIPERA Owner 571-469-7106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2022-11-10 |