| NPI | 1740076413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSUELA DENISE HARRIS Owner 469-401-5133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-08-06 |