| NPI | 1316091200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA SMITH Billing Specialist 512-432-1602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 844396) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: TX 844396) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-07 |