| NPI | 1518235183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA M SMITH Owner 270-904-2260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2015-01-20 |