| NPI | 1528338340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS DANIEL MARQUEZ DE LA PLATA Director 469-975-2411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 33990) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 33990) |
| 103TC0700X Psychologist, Clinical (Licence: TX 33990) | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2019-06-11 |