| NPI | 1023559556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA WELMAN Office Manager 318-432-1463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 19150) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |