| NPI | 1952106882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIDRA THOMPSON Managing Member 601-953-1504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-02-14 |
| Last Update Date | 2025-03-04 |