| NPI | 1609646868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANEL MONIQUE FREEMAN Pmhnp 716-544-1082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-01-08 |