| NPI | 1801651864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKY JAMES JEWELL Advanced Practice Nurse 862-774-4562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-02-19 |