| NPI | 1750046074 |
|---|---|
| Doing Business As | LCDC |
| Entity Type | Organization |
| Authorized Contact | MYLAN WATSON-SHAW Licensed Chemical Dependency 469-321-1346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2021-11-10 |