| NPI | 1821393505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MARKSTROM CFO 318-226-8202 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2016-09-19 |