| NPI | 1427693613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LEIGH GALLE Owner 228-343-0325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2020-08-05 |