| NPI | 1902316359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL SHAW Owner/President 469-640-0392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2022-12-19 |