| NPI | 1902410756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIOBHAN BEATY Licensed Clinical Social Worker 817-891-2886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-08-31 |