| NPI | 1952080723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LIPTAK Nurse Practitioner 330-599-6872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2023-07-17 |