| NPI | 1568280295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER KEENAN Owner/Provider 972-523-6090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |