| NPI | 1609241488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLEY GARDNER Owner/Provider 817-269-1169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP129382) |
| Enumeration Date | 2015-12-05 |
| Last Update Date | 2015-12-05 |