| NPI | 1306303011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMIKA WASHINGTON Owner 662-408-4136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2020-08-04 |