Organization
AUSTIN ADOLESCENT THERAPY
Active
Other names
GirlTalk Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE HOWARD MA (PSYCHOTHERAPIST)
(512) 537-9640
Entity
Organization
Contact information
Practice address
2525 WALLINGWOOD DR, BLDG 1, SUITE 124, AUSTIN, TX 78746-6900
(512) 537-9640
Mailing address
2525 WALLINGWOOD DR, BLDG 1, SUITE 124, AUSTIN, TX 78746-6900
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
201436
TX
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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