| NPI | 1780410001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE BRETON Director 207-204-3671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-09-12 |
| Last Update Date | 2024-09-13 |