| NPI | 1235896853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN HUSEMANN Owner/Provider 563-203-3121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2024-04-22 |