| NPI | 1467233676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL CLARK CEO 830-338-1157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2023-10-12 |