| NPI | 1114487329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL LAWRENCE WARREN Clinical Psychologist 817-292-4179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2019-03-22 |