| NPI | 1881842102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE ANTHONY GUCCIONE CEO 214-348-5557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0004X Psychologist, Health |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2015-01-27 |