| NPI | 1104323799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTITA A LOPEZ Clinical Psychologist 512-497-8018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 32017) |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2018-04-10 |