| NPI | 1346866845 |
|---|---|
| Doing Business As | MAGNOLIA PSYCHIATRY |
| Entity Type | Organization |
| Authorized Contact | KEVIN STUMP Owner 210-787-8973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2024-01-25 |