| NPI | 1922716596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY BAILEY Owner 603-865-7157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2022-11-11 |
| Last Update Date | 2023-09-13 |