| NPI | 1609577550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC-PAUL OLSSON Pmhnp Bc 774-290-4175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-03-16 |
| Last Update Date | 2023-04-04 |