| My Own Counselor | |
|
1101 Ridge Rd 102 Rockwall TX 75087-4250 | |
| (469) 877-6190 | |
| Not Available |
| Full Name | My Own Counselor |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1101 Ridge Rd, Rockwall, Texas |
| Authorized Official Name and Position | Connie Pettitt (MANAGER) |
| Authorized Official Contact | 4698776190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Own Counselor 1101 Ridge Rd 102 Rockwall TX 75087-4250 Ph: (469) 877-6190 | My Own Counselor 1101 Ridge Rd 102 Rockwall TX 75087-4250 Ph: (469) 877-6190 |
| NPI Number | 1659719615 |
|---|---|
| Provider Enumeration Date | 06/11/2013 |
| Last Update Date | 06/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659719615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 68526 (Texas) | Primary |
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