| NPI | 1730952581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA A GILLIANO Owner 904-377-1196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-11-03 |
| Last Update Date | 2023-11-03 |