| NPI | 1710510177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA NICOLE SHARP Owner 210-384-1254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 101YM0800X Counselor Mental Health | |
| 103T00000X Psychologist | |
| 251S00000X Community/Behavioral Health | |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2025-09-03 |