| NPI | 1306509799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORGAN N. IKONNE Ex.Director 302-252-7076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2021-10-21 |