| NPI | 1114284148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLEA TAGGART Office Manager 817-858-6745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 22020) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2012-04-16 |