| NPI | 1194452631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FANETTE PROSPERE Pmhnp/Owner 954-338-9738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2022-08-04 |