Willem H. Fahrenbruck, Lpc, Pllc | |
3122 Nealy Way Ste 201 Longview TX 75605-1092 | |
(903) 452-8040 | |
Not Available |
Full Name | Willem H. Fahrenbruck, Lpc, Pllc |
---|---|
Speciality | Counselor - Professional |
Location | 3122 Nealy Way Ste 201, Longview, Texas |
Authorized Official Name and Position | Willem H. Fahrenbruck (OWNER) |
Authorized Official Contact | 6054402145 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Willem H. Fahrenbruck, Lpc, Pllc 1513 Miami Dr Longview TX 75601-3553 Ph: (605) 440-2145 | Willem H. Fahrenbruck, Lpc, Pllc 3122 Nealy Way Ste 201 Longview TX 75605-1092 Ph: (903) 452-8040 |
NPI Number | 1043062730 |
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Provider Enumeration Date | 04/04/2024 |
Last Update Date | 04/04/2024 |
Certification Date | 04/04/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043062730 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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