| NPI | 1548929060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMENIKE ANIGBOGU Operation Manager 857-234-1295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-12-13 |
| Last Update Date | 2024-11-02 |