| NPI | 1932672649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNMARIE STAATS Owner 512-888-5918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2022-03-03 |