| NPI | 1316590474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MODUPE APASSA Authorized Official/Owner 240-929-4521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2020-03-26 |