| NPI | 1497646657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORCAS WANGARI KANGETHE Owner 315-547-0502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-07-14 |
| Last Update Date | 2026-04-23 |