| NPI | 1790982783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE AARON EASTHAM Executive Director 817-300-1590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 18235) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 5069) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2020-08-22 |