| NPI | 1306536685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURICE E HAYCRAFT Pmhnp Bc 909-275-4798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2025-06-05 |