| NPI | 1578185393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HAWTHORNE Credentialing Coordinator 205-292-2428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-05-14 |