| NPI | 1578272498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEAGAN DAWN CARSON Owner 323-334-0559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2022-11-18 |
| Last Update Date | 2022-11-18 |