| NPI | 1023896651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA NICOLE MANGUM Owner/Nurse Practitioner 775-393-9212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-09-15 |
| Last Update Date | 2024-02-02 |