| NPI | 1629651138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANNE MENDOZA Clinical Mental Health Counselor 469-208-7474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2021-05-03 |