| NPI | 1184480501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN HENRY Nurse Practitioner 770-490-0548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-02-23 |
| Last Update Date | 2024-02-23 |