| NPI | 1730943218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEKESSIA RICHARDS-CARBY Owner 860-655-4986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-02-06 |
| Last Update Date | 2024-02-29 |