| NPI | 1073583589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK B WICHERN President 972-234-3178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist Health Service (Licence: TX 21663) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 21663) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 21663) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2007-08-07 |