| NPI | 1962248286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLORA JESTICE Owner And Provider 802-505-9030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2024-07-27 |