| NPI | 1811351927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE NICKSON-YOUNG CEO 469-231-8206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2016-04-11 |