| NPI | 1841126612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTINE PHILLIPS Provider/Administrator 954-495-8058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2026-06-20 |
| Last Update Date | 2026-06-20 |