| NPI | 1558230664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMEILA YONNIQUE KELLY Owner 904-525-0418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-11-05 |
| Last Update Date | 2025-11-05 |