| NPI | 1407611809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN DOYLE Medical Director 254-519-1144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-02-15 |