| NPI | 1912615428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCEL KAGANOVSKAYA CEO 570-540-2590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2022-12-01 |