| NPI | 1366989881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISSA EDMOND Apn 862-283-7409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ00627000) |
| Enumeration Date | 2017-01-22 |
| Last Update Date | 2017-04-20 |