| NPI | 1609729656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN THOMAS Counselor 779-363-4390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2026-02-18 |
| Last Update Date | 2026-05-18 |