| NPI | 1679312946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER MICHELLE CROUCH Owner/Provider 850-699-4190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-05-24 |
| Last Update Date | 2024-06-21 |