| NPI | 1639781164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY RICHARD Owner 347-834-0484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2025-04-26 |