| NPI | 1154700623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN MASON Billing Manager 817-349-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 17673) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2019-08-22 |