| NPI | 1629386727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE LEE Credentialing Specialist 210-616-0828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 17496) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |