| NPI | 1174288781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI NICHOLSON Licensed Professional Counselor 682-463-1012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2021-12-01 |