| NPI | 1588340749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN GIBSON Owner 603-606-9357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1835P1300X Pharmacist, Psychiatric | |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2024-02-01 |