| NPI | 1902541444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA VALO Owner 239-822-8499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2022-04-29 |