| NPI | 1700496270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY L PIERCE Clinical Director 682-593-5693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2020-08-08 |
| Last Update Date | 2020-08-08 |