| NPI | 1386309318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ZIMMERMAN Owner 270-935-5117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2021-12-05 |