| NPI | 1043614266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA LOGAN Licensed Professional Counselor 469-730-4055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 67137) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2015-07-15 |