NPI | 1114509379 |
---|---|
Entity Type | Organization |
Authorized Contact | JASHUNTA CARSON Nurse Practitioner 682-410-3059 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2021-04-26 |
Last Update Date | 2021-09-01 |