| NPI | 1811053986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN JOHNSON Owner 972-381-1818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 1122-0800) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 9857) |
| 106H00000X Marriage & Family Therapist (Licence: TX 721) | |
| Enumeration Date | 2006-12-31 |
| Last Update Date | 2020-08-22 |