NPI | 1205583515 |
---|---|
Entity Type | Organization |
Authorized Contact | SHERRI L CLARK Owner/Provider 302-744-8086 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
Enumeration Date | 2022-03-07 |
Last Update Date | 2025-02-21 |