| NPI | 1124256664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER GARTH BELLAH Clinical Director 800-377-0998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 32658) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 32657) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2012-01-30 |