| NPI | 1194519363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE KEZIAH THIONGO Owner Of Entity 972-302-1431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-04-04 |
| Last Update Date | 2025-04-04 |