| NPI | 1477066512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLYTHE TWOSISTERS Owner 432-698-0141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 36566) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2017-11-12 |
| Last Update Date | 2021-03-16 |