| NPI | 1083469274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE PERCEFULL Owner/Provider 270-486-1479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-04-22 |
| Last Update Date | 2024-05-26 |