| NPI | 1437520418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA HISAW Owner 361-867-1059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2025-01-23 |