| NPI | 1194451005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA BAKER Nurse Practitioner 682-774-3884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2023-02-16 |