| NPI | 1124566567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE EASTHAM Director 817-276-6412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 103T00000X Psychologist | |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |