| NPI | 1619295425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARQUETTA D COLBERT Owner 937-529-4376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH NP-10322) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2022-03-20 |