| NPI | 1457043184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELBY WASHINGTON Consultant 678-383-0907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2024-04-22 |