| Southlake Child And Family Therapy | |
|
2141 Kirkwood Blvd Ste 130 Southlake TX 76092-1464 | |
| (817) 266-8676 | |
| Not Available |
| Full Name | Southlake Child And Family Therapy |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2141 Kirkwood Blvd Ste 130, Southlake, Texas |
| Authorized Official Name and Position | Katharine Anne Ottone Davis (OWNER) |
| Authorized Official Contact | 8172668676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southlake Child And Family Therapy 1933 Berkeley Pl Fort Worth TX 76110-1209 Ph: (817) 266-8676 | Southlake Child And Family Therapy 2141 Kirkwood Blvd Ste 130 Southlake TX 76092-1464 Ph: (817) 266-8676 |
| NPI Number | 1689387797 |
|---|---|
| Provider Enumeration Date | 01/04/2023 |
| Last Update Date | 01/04/2023 |
| Certification Date | 01/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689387797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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