| NPI | 1366201121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE BLACK Psychiatric Nurse Practitioner 850-661-4731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-03-15 |
| Last Update Date | 2024-04-06 |