| NPI | 1255170502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FOLASHADE TAIWO UMOREN Owner 770-309-4140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-05-24 |
| Last Update Date | 2024-05-24 |