| NPI | 1982076782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD HENRY LANE Executive Director 254-485-6885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 1608) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2015-10-20 |