| NPI | 1528896396 |
|---|---|
| Doing Business As | EVERGRACE HEALTH AND WELLNESS |
| Entity Type | Organization |
| Authorized Contact | TABATHYA STARR TALIAFERRO Sole Owner 580-504-3090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health |
| Enumeration Date | 2024-07-23 |
| Last Update Date | 2025-07-31 |