| NPI | 1679101190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HORTENSE K BISSILA Pmhnp Provider 901-800-1037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2023-02-01 |