| NPI | 1487310256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA ROSE HUDSON DE CORONA Sole Member 205-960-5208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2021-11-16 |