| NPI | 1376872986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN SCOTT ODOM Manager 409-769-8910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 63792) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 62334) |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2009-12-09 |