| NPI | 1912731431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA MICHELLE CORBIN Owner 662-719-7457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-08-27 |
| Last Update Date | 2024-08-27 |