| NPI | 1992571699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELENA LEDFORD Director, Practice Operations 469-765-0627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| 251S00000X | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health | |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry | |
| Enumeration Date | 2023-12-04 |
| Last Update Date | 2023-12-04 |