| NPI | 1013471853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALLEN WALLMAN Licensed Professional Counselor 214-218-4356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2019-01-25 |