| NPI | 1922694827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY LEE Owner 424-223-0421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2021-07-02 |