| NPI | 1114263100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY WILLIAMS Manager 270-900-0094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3006237) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2014-02-28 |