| NPI | 1518619857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MARIE VITALE Psychiatric Nurse Practitioner 708-337-0891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2022-01-18 |