| NPI | 1487912887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENA NELSON Owner 214-335-5715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP115347) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2018-06-08 |