| NPI | 1649678640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY JAMESON Psychotherapist 214-578-2551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 66080) |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2014-12-08 |