| NPI | 1538475595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN B KILLPACK P LLC Member/Manager 956-639-6309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 20280) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 62062) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2010-08-27 |