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 |