| NPI | 1235703968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILAR DAVIDSON Insurance Manager 828-612-4383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2023-03-14 |