NPI | 1679395982 |
---|---|
Doing Business As | LITTLE MOUNTAIN MENTAL WELLNESS |
Entity Type | Organization |
Authorized Contact | THOMAS A DIETZ Authorized Official 210-239-3009 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2024-10-28 |
Last Update Date | 2024-11-21 |