| NPI | 1720537228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RASTONYA L LEE Counselor/Therapist 214-870-9020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: TX 66286) |
| Enumeration Date | 2016-09-25 |
| Last Update Date | 2016-09-25 |