| NPI | 1629266796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE H. FORD President/Owner 754-581-2844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP 9191721) |
| Enumeration Date | 2007-10-14 |
| Last Update Date | 2008-04-01 |