| NPI | 1104402692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMONA DENSIE BEASLEY Managing Member 702-605-2766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2021-03-23 |