| NPI | 1821801390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA BENJAMIN JENKINS Owner 716-817-0234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-01-29 |
| Last Update Date | 2025-01-30 |