| NPI | 1770070070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLYE JOHNSTON LEVINE Manager 512-422-4352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 52338) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |