| NPI | 1013046853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON TANTILLO Lcsw, Lcdc 713-562-3709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 8011) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 36057) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |