NPI | 1194507962 |
---|---|
Entity Type | Organization |
Authorized Contact | TYQUITTA PERRIER Chief Clinical Officer/Owner 706-289-2647 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2023-10-17 |
Last Update Date | 2023-10-17 |