| NPI | 1629852918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE COURDUFF Pmhnp 267-474-9003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-08-21 |