| NPI | 1639875693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THELMA JEAN GRAY Ap RN/Owner 606-545-6766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2023-02-01 |