| NPI | 1679005565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BOWLES Owner/Provider 832-579-8048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 37082) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2017-05-10 |