| NPI | 1871292961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY JOANNA WOMACK Psychiatric Nurse Practitioner 267-206-9086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2024-11-17 |