| NPI | 1629835087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA ERICA OTENG-MENSAH Nurse Practitioner 972-951-0698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-04-17 |