| NPI | 1114756988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY LYONS Owner 800-955-0167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 163WP0808X Registered Nurse, Psych/Mental Health | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2024-07-30 |
| Last Update Date | 2024-07-30 |