| NPI | 1114762291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA KLEMENT Owner 214-876-2203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist Health Service |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| Enumeration Date | 2024-06-28 |
| Last Update Date | 2024-06-28 |