| NPI | 1003643768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRECIOUS JIMBOLA CHANDLER Member 210-809-4289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2024-09-26 |