| NPI | 1629944335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA MERLOS CHINDONGO Psychiatric Nurse Practitioner 857-919-2945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-10-11 |
| Last Update Date | 2025-10-11 |