| NPI | 1366247116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAISSA MURIELLE DYWOU KOUEDE Owner 424-414-3560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-05-19 |