| NPI | 1376973321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J DAHEIM Owner 254-773-0764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 31399) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 31399) |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2017-02-14 |