| NPI | 1437523982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA JOHNSON Owner/Provider 210-919-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 70349) |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2026-06-17 |