| NPI | 1972498251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MARCHESE Practice Manager 972-876-3214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2025-06-09 |