| NPI | 1457692840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCHELLE L STATEN Sole Owner 210-273-9931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 458635) |
| Enumeration Date | 2013-03-08 |
| Last Update Date | 2013-03-08 |