Provider First Line Business Practice Location Address:
1100 STONE ROAD
Provider Second Line Business Practice Location Address:
SUITE 102 BEHAVIORAL EMOTIONAL COUNSELING SERVICES
Provider Business Practice Location Address City Name:
KILGORE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75662-5494
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-986-9114
Provider Business Practice Location Address Fax Number:
903-988-0243
Provider Enumeration Date:
09/28/2006