| NPI | 1205505674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARA CONRAD-SHEARBURN Licensed Psychologist 210-819-5941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2021-09-09 |