| NPI | 1265855712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN MARIE THEBO Owner/Lcsw 325-939-7641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 50867) |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2016-02-23 |