| NPI | 1730719790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIA BILLY CROSSLEY Licensed Psychologist 979-571-2077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 103TS0200X Psychologist, School | |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2020-01-18 |
| Last Update Date | 2020-01-18 |