| NPI | 1891001996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE REIDY Owner And Nurse Practitioner 013-934-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MD R162903) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: MD R162903) | |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2023-07-21 |