| NPI | 1720734247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA GAIL SMALLMON CEO 870-970-3180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 163WW0000X Registered Nurse, Wound Care | |
| 174400000X Specialist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2022-02-23 |
| Last Update Date | 2024-05-11 |