| NPI | 1790273308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE A. LOPEZ Owner 716-908-1711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY f400896) |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2018-04-30 |