| NPI | 1114509056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOPHIE GWELO Owner Of Entity 214-335-9784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2024-08-08 |