| NPI | 1801581558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOFOWOROLA EKADI Manager 817-293-8797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-04-10 |