| NPI | 1942191655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA LOGANG Managing Director 347-209-0881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2025-07-10 |