| NPI | 1831865153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY FORD Nurse Practitioner 603-667-6743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-08-17 |