| NPI | 1487316576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA LYNN MCGLONE Owner/Member 479-518-8549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2022-08-25 |