| NPI | 1912874314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YEGANEH JALAEIAN Np 571-200-3284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-10-20 |
| Last Update Date | 2025-10-20 |