| NPI | 1710688171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE FLORENCE MATTINGLY Pmhnp Bc 719-650-0438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2023-03-13 |