| NPI | 1528993706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH TAMUNOPRINYE OGOLO Owner 469-237-0381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2026-06-17 |
| Last Update Date | 2026-06-17 |