NPI | 1972181642 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAWNDELE LANIK DANZY Owner 803-518-9079 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
Enumeration Date | 2021-04-01 |
Last Update Date | 2023-05-15 |