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3317 Finley Rd Suite 168 Irving TX 75062-8722 | |
(972) 570-9828 | |
Not Available |
Full Name | |
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Speciality | Counselor - Professional |
Location | 3317 Finley Rd, Irving, Texas |
Authorized Official Name and Position | Robert L. Gilliam (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9725709828 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3317 Finley Rd Suite 168 Irving TX 75062-8722 Ph: (972) 570-9828 | 3317 Finley Rd Suite 168 Irving TX 75062-8722 Ph: (972) 570-9828 |
NPI Number | 1609143171 |
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Provider Enumeration Date | 11/28/2011 |
Last Update Date | 11/28/2011 |
Identifier | Type | State | Issuer |
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1609143171 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | 9559 (Texas) | Secondary |
101YP2500X | Counselor - Professional | 9559 (Texas) | Primary |
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