| NPI | 1982142568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI BRUNK Office Manager 254-221-0299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 104100000X Social Worker | |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2017-02-03 |