| NPI | 1780493551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH GIBSON Co Owner 210-414-5789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-01-06 |