| NPI | 1346099074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORTNEY BERKLEY Owner 254-212-8014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2024-05-15 |