| NPI | 1477857704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY RENEE GOSHORN Owner 641-205-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: IA G-096742) |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2024-05-31 |