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NPI Profile for AUTOSPA HEALTHY YOUTH CENTER in CLARKSDALE, MS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner |
| NPI # | 1063957751 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 01/04/2017 | |
| Last updated | 01/04/2017 - About 9 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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AUTOSPA-HEALTHY YOUTH CENTER
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AUTOSPA-HEALTHY YOUTH CENTER