| NPI | 1316533896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TESHERA TULL-YEARWOOD Owner 857-247-3180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2020-12-18 |
| Last Update Date | 2020-12-18 |