| NPI | 1265977557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD SCOTT WALLACE State Director 512-343-8606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM 1044) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2016-12-22 |