| NPI | 1992270995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE MARTIN Owner/ Provider 228-547-1945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2020-08-18 |