| NPI | 1194958769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEDRICK WALES JACKSON Owner 214-519-9473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 41529) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2011-11-23 |