| NPI | 1356036529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIODUN OLATUBOSUN Nurse Practitioner, Psych 551-275-5674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-04-05 |
| Last Update Date | 2023-04-05 |