| NPI | 1306952304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE LAYNE Office Manager 210-800-6146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 6460) |
| 101YP2500X Counselor, Professional (Licence: TX 19744) | |
| 104100000X Social Worker (Licence: TX 25003) | |
| 1041C0700X Social Worker, Clinical (Licence: TX 27629) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2020-10-28 |