| NPI | 1205613007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA NAEVA Nurse Practitioner 508-779-6436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-09-13 |
| Last Update Date | 2023-09-13 |