| NPI | 1265744700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOIS M LEISTNER Owner 850-325-6590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP1654742) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-07-13 |