| NPI | 1235420076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA L. JACKSON Clinical Psychologist 214-356-0335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 34857) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2012-03-23 |