| NPI | 1710754551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER M AMEZQUITA Owner/Registered Agent 915-345-9726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2023-12-11 |