| NPI | 1902414402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA HARLAN Credentialing Manger 830-730-5025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical | |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2023-05-25 |