| NPI | 1487202982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JOHNSON Owner/Provider 302-276-8576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2019-08-28 |