| NPI | 1992586390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS CATHERINE NYOTTA Owner 443-616-9560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2023-10-12 |