| NPI | 1346954617 |
|---|---|
| Former Legal Business Name | SPERO'S LIGHTHOUSE |
| Entity Type | Organization |
| Authorized Contact | HALEE FULLERTON Pmhnp Bc 620-391-1737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2023-01-10 |