| NPI | 1356753362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA D HENSLEY Psychologist 817-962-0035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36730) |
| Enumeration Date | 2014-05-25 |
| Last Update Date | 2014-05-25 |