| NPI | 1700342607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON RENFRO Owner 469-867-7365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2019-02-15 |