| NPI | 1588775969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH ERIC DUBOIS Owner 361-225-3944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 23057) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-10-07 |