| NPI | 1073379566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY WARFIELD Part Owner 469-810-1361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 261QC1500X Clinic/Center, Community Health | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-02-22 |
| Last Update Date | 2024-02-22 |