| NPI | 1588344857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA SPEARS Administrative Clerk 605-517-1064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-07-21 |
| Last Update Date | 2023-08-04 |