| NPI | 1225757446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANNA WICINSKI Psychiatric Nurse Practitioner 224-234-9299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2024-08-04 |