NPI | 1003192923 |
---|---|
Entity Type | Organization |
Authorized Contact | AMBER KUNTZ Licensed Counselor Supervisor, Owne 940-535-4375 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: TX 19993) |
Enumeration Date | 2011-10-24 |
Last Update Date | 2011-10-24 |