| NPI | 1700504370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A KUOPUS Owner/Employee 906-361-4337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2022-08-18 |