| NPI | 1952654006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA FORTNER Therapist 972-375-8268 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 67702) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2012-10-25 |