| NPI | 1740949361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARIDY MAYA MOMBELEUR Psychiatric Nurse Practitioner 469-445-6366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2021-12-10 |