| Willow Lane Health Llc | |
|
1288 Blue Lake Dr Frisco TX 75033-1437 | |
| (828) 506-0718 | |
| Not Available |
| Full Name | Willow Lane Health Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1288 Blue Lake Dr, Frisco, Texas |
| Authorized Official Name and Position | Brian Fisher (OWNER) |
| Authorized Official Contact | 2143850180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Lane Health Llc 1288 Blue Lake Dr Frisco TX 75033-1437 Ph: () - | Willow Lane Health Llc 1288 Blue Lake Dr Frisco TX 75033-1437 Ph: (828) 506-0718 |
| NPI Number | 1689277352 |
|---|---|
| Provider Enumeration Date | 11/17/2020 |
| Last Update Date | 01/07/2021 |
| Certification Date | 01/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689277352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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