| NPI | 1730554999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY HICKS Owner 903-234-8755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: TX AP125290) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2022-11-14 |