| NPI | 1588246730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA CLEMENT-DEFALCO Owner 434-851-6404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2021-06-29 |