| NPI | 1972243541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYNE JONES-JENKINS Owner 339-999-2794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-05-20 |