| NPI | 1790260107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRISELDA P OAXACA Owner/Director 915-613-3989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2018-10-02 |