| NPI | 1760249213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD LEE KENNEDY Psychiatric Nurse Practitioner 937-552-5598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-03-01 |
| Last Update Date | 2024-03-01 |