| NPI | 1821850769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEROY SCOTT Owner 800-377-5668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-01-26 |
| Last Update Date | 2024-01-26 |