| NPI | 1104328723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDR VATTAMALA PHILIP Licensed Professional Counselor 214-436-2272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 74513) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-02-28 |