| NPI | 1659782878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY STEPHEN GALLUP Owner 214-952-2324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 61332) |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2014-05-09 |