| NPI | 1376222901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY CAROL EDO Business Owner 225-256-4764 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2024-03-06 |