| NPI | 1003551391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGATHER AUMA ONYANGO Psychiatric Nurse Practitioner 682-217-0711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-01 |
| Last Update Date | 2022-07-22 |