| NPI | 1467392001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHA MARTINA ANDERSON Owner 754-300-7775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2026-04-01 |
| Last Update Date | 2026-04-23 |