| NPI | 1992440259 |
|---|---|
| Doing Business As | KEISHA COLEMAN |
| Entity Type | Organization |
| Authorized Contact | HEATHER WILSON Credentialing Manager 903-818-8312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2023-03-11 |