| NPI | 1760343420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIANCA FERGUSON Nurse Practitioner 678-216-7151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-11-21 |
| Last Update Date | 2025-11-21 |