| NPI | 1912389081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAIN STORDAHL Business Manager 512-537-7976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 34166) |
| Additional Taxonomies | 251S00000X (Licence: TX 34166) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2021-08-16 |