NPI | 1508106048 |
---|---|
Entity Type | Organization |
Authorized Contact | SONJA L. SHIPP Sole Member 469-730-3360 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 65614) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11144) |
Enumeration Date | 2013-02-20 |
Last Update Date | 2013-04-26 |