| NPI | 1639940554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALECHIA PARKER Office Manager 318-237-0023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2024-04-25 |