| NPI | 1689082224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL GORDON Billing Specialist 512-343-8307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 61629) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2014-07-28 |