| NPI | 1215292081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. TODD BAKER Lpc/Owner 817-812-2880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 65472) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2012-07-09 |