NPI | 1568118800 |
---|---|
Entity Type | Organization |
Authorized Contact | MAGENTA HALL Owner Of Entity 850-879-1164 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2022-02-24 |
Last Update Date | 2022-12-30 |