| NPI | 1861376477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA JUNE CLEMONS Psychiatric Nurse Practitioner 817-301-6277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-08-05 |
| Last Update Date | 2025-08-05 |