| NPI | 1407682594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LEE LEITE Owner 302-401-1005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2024-09-13 |
| Last Update Date | 2024-09-13 |