| NPI | 1932097441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA CLOUGH Licensed Clinical Social Worker 817-646-0825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-06-24 |
| Last Update Date | 2025-07-01 |