| NPI | 1821798414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA MICHELLE BAXTER Owner 386-232-8089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-03-03 |
| Last Update Date | 2024-11-12 |