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 | 2024-11-05 |