| NPI | 1548086366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA HARVEY Ap RN 308-530-7021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2024-11-26 |
| Last Update Date | 2025-01-31 |