| NPI | 1245646843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY LACOUTURE Owner 979-739-1724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: LA AP07692) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2014-07-03 |