| NPI | 1780367128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTNI ROLDAN Pmhnp 618-472-6650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2023-08-11 |