| NPI | 1801185301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER S STASIAK Owner 972-839-6099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: TX PA00801) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2011-06-24 |