| NPI | 1548786478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL WICHMAN Member Manager 972-977-0203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: TX 70313) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2023-06-12 |