| NPI | 1720876147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY AGU PARKER Owner 401-388-0422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine |
| Enumeration Date | 2025-04-26 |
| Last Update Date | 2025-04-26 |