| NPI | 1639790967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY BEAUREGARD ALLEN Pmhnp Bc/Owner 731-609-8992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2024-11-01 |