| NPI | 1679155667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANA VALENTE GRACIO Therapist 531-239-4701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2021-04-28 |