| NPI | 1093230823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANAZ SARA IKONNE Owner 469-626-9085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 73271) |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2017-08-15 |