| NPI | 1124570114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA SHELTON Credentialing Clerk 903-422-0429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 6388) |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2022-12-29 |