| NPI | 1225475049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA MCMAHON Admnistrator 682-323-2889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 65858) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 66531) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2013-06-03 |