| NPI | 1548782782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY A VAN HORN Managing Member 432-208-3347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 64053) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2017-07-10 |