| NPI | 1003604323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA JAIYESIMI Owner 469-844-7061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-04-28 |
| Last Update Date | 2025-05-06 |