| NPI | 1619497526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE SIAS Clinical Social Worker 817-357-6309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 56398) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-07-21 |