| NPI | 1235002494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BRANNON PATRICK Owner 385-224-5128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-09-24 |
| Last Update Date | 2025-09-25 |