| NPI | 1760935720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN DANFORD Director Administrative Services 979-822-6467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 72167) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2016-07-26 |