| NPI | 1922855121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISH V WILLIAMS-FORDE Owner Of Entity 424-248-1182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-05-04 |
| Last Update Date | 2026-06-09 |