NPI | 1710622675 |
---|---|
Doing Business As | ANGELA STATHOPOULOS |
Entity Type | Organization |
Authorized Contact | JESSICA MARIA CAMPOS Office Manager 517-347-4848 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2022-05-04 |
Last Update Date | 2022-05-04 |