| NPI | 1477318038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESTINY DEBORA COLEY REFUSE Manager 727-501-5621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-02-13 |
| Last Update Date | 2024-02-13 |