| NPI | 1144804568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAIGINA L PRESTON Np/Owner 469-489-0070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2021-05-11 |