| NPI | 1295465870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY KELLEY Office Administrator 318-331-0184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2022-07-18 |