| NPI | 1205415981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY MICKLE CEO 279-895-4958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2024-03-02 |