| NPI | 1073345708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENEICE WICKENS Owner/Provider 832-833-4125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |