| NPI | 1093159824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE IACUONE Licensed Professional Counselor 210-408-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 62105) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2013-04-23 |