| NPI | 1184413999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLEEN WILDER Clinical Director 972-519-1692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-05-06 |
| Last Update Date | 2025-05-06 |