| NPI | 1689615148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA ALEXANDER-COOK President 234-312-5873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC0700X Psychologist Clinical | |
| 104100000X Social Worker | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2019-06-20 |