| NPI | 1285479238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDOGHOGHO EDOSONMWAN Np 469-442-9930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-06-29 |
| Last Update Date | 2024-08-07 |