| NPI | 1851698682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA ROXANE LONG Pmhnp, President 954-851-9690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9312887) |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2013-08-05 |