| NPI | 1710251012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN A CHINWEZE Administrator 903-581-7973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TR0400X Psychologist Rehabilitation | |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2012-04-16 |