| NPI | 1194192005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL BLACKMON Executive Director 817-413-9463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 15675) |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2015-08-26 |