| NPI | 1154797694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR WIESNER Owner, Founder 936-554-1616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 174400000X Specialist |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |