| NPI | 1225763568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN M BROCK Owner 817-729-9099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2024-03-14 |