| NPI | 1639678113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN TALMAGE Owner 214-206-6822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 24635) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2020-08-12 |