| NPI | 1932476009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY CLOUSTON Owner 512-329-9455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 50296) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: TX 50296) |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2012-09-28 |