| NPI | 1790664647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY DUBOSE Psychiatric Nurse Practitioner 401-602-3938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-08-27 |
| Last Update Date | 2025-08-27 |