| NPI | 1386362762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE STOLTE Owner 979-257-8224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2022-08-22 |