| NPI | 1598483455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORAWAN BETH GARDNER Nurse Practitioner 203-303-9262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-08-17 |
| Last Update Date | 2023-03-12 |