| NPI | 1609611383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGETTE DENISE AGEE CEO 863-225-2355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2024-06-26 |