| NPI | 1730077587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMA THOMPSON Advanced Practice Nurse 862-205-9591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-06-27 |
| Last Update Date | 2025-09-09 |