| NPI | 1699582775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHINWE ASIDANYA Sole Owner 469-226-3415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-12-12 |
| Last Update Date | 2025-01-24 |