| NPI | 1912716804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOURDES CASTRO Credentialing Specialist 203-503-3281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-01-06 |