| NPI | 1710581905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA WOODBURN COMEAU Owner 917-693-8488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-11-28 |
| Last Update Date | 2023-03-02 |