| NPI | 1740412204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRI L PEDRO Owner 817-665-0583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 62483) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 209525) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2009-08-18 |