| NPI | 1952854481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA L KELLY Owner 949-274-2881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201604186NP-PP) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2016-08-03 |