| NPI | 1285522805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM FONCHAM NGWA President/Owner 856-889-7288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-06-24 |
| Last Update Date | 2025-08-27 |