| NPI | 1760844195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS LEOS Clinic Director 469-660-8620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 63241) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 201213) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2016-03-24 |