| NPI | 1720784903 |
|---|---|
| Former Legal Business Name | INTO THE ROOTS THERAPY, PLLC |
| Entity Type | Organization |
| Authorized Contact | PHI-LONG LE Owner/Provider 512-366-0178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2024-10-22 |