| NPI | 1245943356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE JAYNES Owner 606-304-3794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2023-01-04 |
| Last Update Date | 2023-01-08 |