| NPI | 1568284008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEMILOLUWA O ILESANMI President 540-698-4259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2024-10-28 |