| NPI | 1477442986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE PRAKOPE Owner/Provider 201-600-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-06-30 |
| Last Update Date | 2025-08-11 |