| NPI | 1881215580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN MARIE CLEMENS Practice Owner 877-588-0282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2023-04-06 |