| NPI | 1023284320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA LYNN RANDOLPH AUVENSHINE Licensed Professional Counselor/Own 817-446-5591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: TX 19708) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2008-05-06 |