| NPI | 1902595770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY IMOLEAYO OKEYEMI Owner 469-245-4643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-05-05 |