| NPI | 1861976177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANA JOY DONOFRY Managing Member 907-328-0820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2018-09-21 |