| NPI | 1619592722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY A RADTKE Lpc, Lmft 972-824-6177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2025-01-29 |