| NPI | 1548092596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE MARIE DAVIS Nurse Practitioner 518-690-6275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |