| NPI | 1740932771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PETERSON Owner 210-935-2609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2022-01-20 |