| NPI | 1740631654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE DAWN LANSBERY President 512-689-6477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 64199) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 35324) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |