| NPI | 1184361024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLADUNNI BOLADALE Nurse Practitioner 331-246-6564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2026-04-07 |