| NPI | 1255074860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA SHUCK Owner / Counselor 940-220-8335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2024-10-01 |