| NPI | 1639567654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE A EASTHAM Executive Director 817-416-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 5069) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 18235) |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2014-12-29 |