| NPI | 1316390693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE FONTENOT Director 280-717-3099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 57323) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2016-07-21 |