| NPI | 1043917719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER GERACIE A VP Clinical Excellence 817-242-0967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-02-13 |