| NPI | 1821783168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALINA WILLIAMS Owner 662-390-6052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2023-05-03 |