| NPI | 1992422430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA L GOMEZ Credentialing Manager 512-551-1717 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2022-10-25 |
| Last Update Date | 2022-10-25 |