| NPI | 1720202476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA C WAGNER Proprietor 915-585-9760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 12443) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-11-23 |