| NPI | 1982000741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYREASEA A JOHNSON-MASON Owner 609-350-4792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NJ 26NJ00429100) |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2015-01-22 |