NPI | 1902530124 |
---|---|
Entity Type | Organization |
Authorized Contact | ELISABETH PESCE Secretary 904-605-4986 |
Organization Subpart ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2022-07-13 |
Last Update Date | 2023-03-15 |