| NPI | 1336532464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA P WILSON Owner 361-937-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TX 735117) |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2015-03-13 |