| NPI | 1740789817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE A PASSALACQUA Owner 512-423-7331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 73032) |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2018-02-05 |