| NPI | 1356152755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE MARIE TANQUE Owner 508-400-7765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-01-15 |
| Last Update Date | 2025-01-15 |