| NPI | 1417666504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI GULLEY Clinical Psychologist 254-262-6836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist, Clinical | |
| 103TC1900X Psychologist, Counseling | |
| 103TP0814X Psychologist, Psychoanalysis | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2022-11-17 |