| NPI | 1255010765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD EDWARD NISSLEY Psychologist 903-471-0274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2023-07-12 |