| NPI | 1326799081 |
|---|---|
| Doing Business As | AFFECT PROVIDER GROUP, P.C. |
| Doing Business As | AFFECT PROVIDER GROUP |
| Entity Type | Organization |
| Authorized Contact | KARLA RENEE MULLINGS Director Of Compliance 845-769-8758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-01-14 |
| Last Update Date | 2023-09-22 |