| NPI | 1205248150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA KELLAM Owner/Psychologist 817-313-7899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 32518) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |