| NPI | 1275029811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY ELLEN KTEILY Owner 972-304-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 17316) |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2021-09-23 |