| NPI | 1730626060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY L DICKINSON GRAY Lpc, Lmft A, 281-223-3421 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 70550) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |