| NPI | 1811358492 |
|---|---|
| Doing Business As | WESTSIDE MENTAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | TAMMY JO COOMER BRADFORD President 507-779-4795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: IN 70000195A) |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2016-04-01 |