| NPI | 1518457712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC LEE ANSON Owner And Program Director 385-439-1926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 5780998-3501) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2019-12-19 |