| NPI | 1841943040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOLATITO OYERONKE OKOUGBO Pmhnp 623-398-9124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2023-03-07 |