| NPI | 1962234096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH JACKS Co Owner 817-438-2917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2024-08-23 |