| NPI | 1578173738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRIVIA GUINN Owner 517-240-2998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2022-03-18 |