Doctor Name: | MR. DAVID R WELLS |
NPI Number: | 1083914196 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA, LPC |
License Number: | 15643 |
Business Practice Address: | 543 William D Fitch Pkwy Ste 111 C/o Cs Christian Counseling College Station, TX - 778456142 |
Business Phone Number: | 9792163020 |
Business Fax Number: | |
Mailing Address: | 543 William D Fitch Pkwy Ste 111, C/o Cs Christian Counseling COLLEGE STATION |
State: | TX |
Postal Code: | 778456142 |
Phone Number: | 9792163020 |
Fax Number: | |
NPI Enumeration Date: | 10/25/2010 |
NPI Last Update Date: | 05/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 15643 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |