| NPI | 1225806672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANISE BASTIEN Ap RN, Pmhnp Bc 561-608-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-12-14 |
| Last Update Date | 2023-12-14 |