| NPI | 1649714585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LYNN CHEATHAM President 817-228-1668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 65475) |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2016-12-12 |