| NPI | 1881101780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARKALISE MITCHELL Senior Credentialing Specialist 281-541-8674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2022-03-10 |