| NPI | 1598464661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE AIBANGBEE Authorized Official 470-451-3341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2024-05-28 |