NPI | 1326769829 |
---|---|
Entity Type | Organization |
Authorized Contact | KRISTEN LEE MANRODT Owner 440-381-8237 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2022-09-05 |
Last Update Date | 2025-01-14 |