| NPI | 1649640400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY J EVANS Owner 662-620-7102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MS R543446) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2015-10-05 |