| NPI | 1619579018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALENTINE BUSOGI Owner 469-486-1889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2021-03-09 |