| NPI | 1326821620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA MARIE TILLEMANS Partner/Provider 775-247-7624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2023-08-18 |