NPI | 1285443168 |
---|---|
Entity Type | Organization |
Authorized Contact | AEISHA DAVIS Owner 443-220-1047 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2025-01-06 |
Last Update Date | 2025-05-07 |