| NPI | 1164756565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA LYNN HODGES Psychologist 254-776-7792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 2-5171) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2009-10-01 |