| NPI | 1821869165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASTITY STEPHENS Owner 501-513-7264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-01-15 |