| Theokratia Psychotherapy Pllc | |
|
1910 Pacific Ave Ste 14225 Dallas TX 75201-4773 | |
| (469) 755-6933 | |
| Not Available |
| Full Name | Theokratia Psychotherapy Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1910 Pacific Ave Ste 14225, Dallas, Texas |
| Authorized Official Name and Position | Crystal Robinson (OWNER/LMFT) |
| Authorized Official Contact | 4697556933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theokratia Psychotherapy Pllc 4821 Hazelhurst Ln Dallas TX 75227-2941 Ph: (469) 755-6933 | Theokratia Psychotherapy Pllc 1910 Pacific Ave Ste 14225 Dallas TX 75201-4773 Ph: (469) 755-6933 |
| NPI Number | 1801494752 |
|---|---|
| Provider Enumeration Date | 10/13/2020 |
| Last Update Date | 10/13/2020 |
| Certification Date | 10/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801494752 | NPI | - | NPPES |
| 373381802 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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