NPI | 1578234506 |
---|---|
Entity Type | Organization |
Authorized Contact | BARBARA JO HAYES Owner Provider 980-705-1620 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2021-09-21 |
Last Update Date | 2024-11-20 |