| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 613 Fox Gln, Forney, Texas |
| Authorized Official Name and Position | Erin Tatum James (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 2142322265 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
613 Fox Gln Forney TX 75126-4775 Ph: (214) 232-2265 | 613 Fox Gln Forney TX 75126-4775 Ph: (214) 232-2265 |
| NPI Number | 1093124018 |
|---|---|
| Provider Enumeration Date | 08/04/2014 |
| Last Update Date | 08/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093124018 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 63911 (Texas) | Primary |
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