| NPI | 1568896488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS DARYL WHITTINGTON Practice Manager 469-232-9596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 58655) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 15198) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2013-08-27 |