| NPI | 1033375142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK SMYTH Registered Agent 214-319-9447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX LPC 13621) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2008-07-29 |