| NPI | 1265124804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYNEAH MORRIS Nurse Practitioner 937-830-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2023-05-23 |