| NPI | 1689196651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOLUTIFE DOSUMU Therapist 817-705-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 51608) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2023-11-08 |