| NPI | 1972347193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIANA JOHNSON BLANTON Therapist & Clinical Director 469-340-2887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2024-06-21 |
| Last Update Date | 2024-07-01 |