| NPI | 1063832954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LEE SOULSBY Owner 210-694-1311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 52488) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2014-04-18 |