| NPI | 1982598199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE BONE Credentialing Admin 214-764-9915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-06-04 |
| Last Update Date | 2025-06-12 |