| NPI | 1730215724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTT EUGENE CONNIE Co Director, Associate Therapist 817-870-1080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 62681) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 62681) |
| 101YP2500X Counselor, Professional (Licence: TX 62681) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |