| NPI | 1083914006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE FLATLEY JACKSON Sole Mbr 915-203-6824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 552302) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2011-04-06 |