| NPI | 1972113124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY FARMER VICKERS Pmhnp/Owner 985-774-4989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2023-08-16 |