| NPI | 1306019468 |
|---|---|
| Other Name | ANDRE PUNCH |
| Entity Type | Organization |
| Authorized Contact | JOE EASTHAM Executive Director 817-300-1590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2008-04-10 |