| NPI | 1841026440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LACOUTURE Pmhnp 563-340-8470 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-10 |