| NPI | 1891373437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEMPHIS CHARDELL SANDOVAL Psychiatric Nurse Practitioner 231-327-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2024-10-11 |