| NPI | 1982062816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA L BRAY Co Owner 512-636-0104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: TX 36270) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 54539) |
| Enumeration Date | 2016-02-06 |
| Last Update Date | 2016-02-06 |