| NPI | 1063297349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY NELSON Therapist 979-739-4269 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2023-08-25 |