| NPI | 1689051096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI TERRY Owner 214-734-4549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP111242) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2015-05-05 |