| NPI | 1871184424 |
|---|---|
| Other Name | ILLUMINATE NP PSYCHIATRY, PLLC |
| Entity Type | Organization |
| Authorized Contact | AMY KOTARSKI Owner 716-903-6036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2024-03-06 |