| NPI | 1285479758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NERILENE LEENA BALLARD Owner Of Entity 754-280-0137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2024-06-27 |