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1083474530
KINO PARK
AUSTIN, TX
NPI
1083474530
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: TX 107952)
Enumeration Date
2024-03-21
Last Update Date
2024-03-21
Business Address
KINO PARK
802 LYDIA ST
AUSTIN, TX 78702-2623
Phone number: 512-380-1684
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Mailing Address
KINO PARK
802 LYDIA ST
AUSTIN, TX 78702-2623
Phone number:
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