| NPI | 1588523732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY ALLEN HADDOX Managing Member 937-694-8757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2026-01-21 |
| Last Update Date | 2026-01-21 |