| NPI | 1801659297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYANN M EFESOA Nurse Practitioner 469-309-7835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2025-02-01 |