| NPI | 1578094017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA AURORA CHAMPION Owner 346-235-3939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 63471) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-03-27 |