| NPI | 1659153450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASIE MICHELLE CASSELL Owner 703-423-9704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2023-10-17 |