| NPI | 1447990858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY DENISE GARCIA Provider 704-728-3406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-04-01 |