| NPI | 1982479176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA YOSHIKO CARTER Ownwe 601-504-0180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2023-11-27 |