| NPI | 1902684608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA D MALONSON Nurse Practitoner/Owner 985-285-6843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-09-15 |
| Last Update Date | 2023-09-15 |