| NPI | 1891801817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN S DEWOLFE Owner 065-497-3254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MT RN16128) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2019-10-10 |