| NPI | 1720440787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA T LIPPINCOTT Owner 662-844-3728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MS R679054) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2016-03-28 |