| NPI | 1851811616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY C LU Credentialing Manager 904-221-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL RN3150732) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2022-07-21 |