| NPI | 1992560411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONITA NULLA Owner 240-705-3324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-02-14 |
| Last Update Date | 2024-02-14 |