| NPI | 1588773220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC H MCQUEEN Clinical Director 432-570-1084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 14525) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 004772042983) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-22 |