| NPI | 1700590650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH WALT BULMER Provider 832-298-1763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-01-05 |