| NPI | 1912612904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENYONAM JORDAN-BRANGMAN Nurse Practitioner 571-247-4434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2023-01-16 |