| NPI | 1184700361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY M LEWIS Credentialing 903-957-4869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2022-10-27 |