| NPI | 1841937893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALIMATA SORE OUEDRAOGO Owner 216-235-5484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2026-08-13 |