| NPI | 1841399789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY NEWBERRY Office Manager 270-360-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-11-24 |