| NPI | 1861071912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS ALDEN BAIRD President 917-873-5716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-04-15 |