| NPI | 1992239412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DOYLE CFO 469-341-8804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2019-06-04 |