| NPI | 1700624954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH NYAIRO Owner/Authorized Official 817-323-0159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-07-19 |
| Last Update Date | 2024-07-25 |