| NPI | 1215813910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN CANNONE Owner 888-705-8722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-08-15 |
| Last Update Date | 2025-08-15 |