| NPI | 1598426645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSINE WOCTCHOU Pmhnp 770-906-3430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-12-30 |
| Last Update Date | 2023-02-21 |