| NPI | 1275711236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN L. GIBBLE Member 888-517-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: DE LE-0000158) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000571) |
| 133V00000X Dietitian, Registered (Licence: DE DN-0000351) | |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2014-03-03 |