| NPI | 1235579178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN D ODOM Psychologist 210-698-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 33728) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2013-06-25 |