| NPI | 1285119925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMOLOLA A OTUBAGA Ap RN Bc/Nurse Practioner 404-444-1904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2023-04-25 |