| NPI | 1871365239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOIS A JOHNSON Nurse Practitioner/Owner 505-800-7335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-10-27 |
| Last Update Date | 2023-10-27 |