| NPI | 1386421915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVY NNOROM Nurse Practitioner/Owner 862-888-2001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2023-09-27 |