| NPI | 1659049757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER POTTER COO 972-656-9650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2021-09-02 |