| NPI | 1043785124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY CLARK Owner/Nurse Practitioner 225-255-0899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2024-05-15 |