| NPI | 1578454518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUELINDA TILLMAN-WILSON Owner/Pmhnp 501-470-8265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-07-09 |
| Last Update Date | 2025-07-09 |