| NPI | 1902630114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON GRIMES Nurse Practitioner 234-313-5870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2024-08-29 |