| NPI | 1508401571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN RENEE DAVIES Member 607-245-9308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2019-12-10 |