| NPI | 1730524174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER R BURGESS Managing Psychologist 817-559-4045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 32262) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2013-07-02 |