| NPI | 1750799326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA NDORO Proprietor 671-454-4186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN27515) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2020-08-31 |