| NPI | 1861081549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY WAYNE GRAHAM Clinical Director 325-277-9198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2022-07-14 |