| NPI | 1699482521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABITHA MCJUNKINS Nurse Practitioner/Owner 662-202-4452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2022-10-31 |