| NPI | 1851851133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AZIM NASIR Member 972-795-3422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 103TC0700X Psychologist, Clinical | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2019-11-22 |