| NPI | 1205680303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA L GOMEZ Credentialing Manager 512-508-3941 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-04-15 |