| NPI | 1417385535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMLYNN LEIGH EVANS Owner 2319-359-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MI 4704144584) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |