NPI | 1104572296 |
---|---|
Entity Type | Organization |
Authorized Contact | JEREMY DILLON Practice Manager 512-528-3131 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP2500X Counselor, Professional | |
103K00000X Behavior Analyst | |
103TC0700X Psychologist, Clinical | |
103TC1900X Psychologist, Counseling | |
104100000X Social Worker | |
1041C0700X Social Worker, Clinical | |
Enumeration Date | 2022-02-27 |
Last Update Date | 2024-12-03 |