| NPI | 1225656747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATRENA BOSWELL Therapist 817-385-1529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-07-10 |