| NPI | 1952882979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANA BAGGETT TALBOTT President 325-500-8465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 37906) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 20134) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |