| NPI | 1467141622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AISHA AYANNA ADDISON Psychiatric Nurse Practitioner 302-273-3926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2024-08-20 |