| NPI | 1972260370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENNARD DARYL LATHAN Licensed Professional Counselor 214-530-9377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2024-01-04 |