| NPI | 1821668088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKISHA COLE Credentialing 409-344-0851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208000000X Pediatrics |
| 235Z00000X Speech-Language Pathologist, | |
| 251B00000X Case Management | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 251S00000X Community/Behavioral Health | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 101YP2500X Counselor, Professional | |
| 106S00000X Behavior Technician | |
| 103TC0700X Psychologist, Clinical | |
| 363LC1500X Nurse Practitioner, Community Health | |
| 207Q00000X Family Medicine | |
| 171M00000X Case Manager/Care Coordinator | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2025-12-23 |