| NPI | 1720715543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASIA HENDERSON Nurse Practitioner 401-287-8810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2024-05-28 |