| NPI | 1346520293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW GILL Counselor 817-360-5364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 62128) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 62128) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 10377) | |
| 101YP2500X Counselor, Professional (Licence: TX 62128) | |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2012-11-12 |