| NPI | 1528459914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE D GORTNEY Counselor/Director 817-913-1517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 19940) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 38240) |
| Enumeration Date | 2015-02-06 |
| Last Update Date | 2015-02-06 |