| NPI | 1932706512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE SHEREE EAKINS Owner 940-500-4408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2021-04-28 |