| NPI | 1396524005 |
|---|---|
| Former Legal Business Name | MOMMIHEALTH PLLC |
| Entity Type | Organization |
| Authorized Contact | JESSICA GAULTON Owner 267-432-4575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2023-09-22 |
| Last Update Date | 2024-06-14 |