| NPI | 1497273759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM C CARSON Counselor 972-743-2324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 19454) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 68346) |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2017-09-06 |