| NPI | 1295519213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA KOUPAL Business Owner 605-431-3388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-09-07 |