| NPI | 1033819511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LYNN VELASQUEZ Owner 901-568-8843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-03-03 |
| Last Update Date | 2023-03-03 |