Doctor Name: | EMMY BEAN |
NPI Number: | 1134536741 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 69283 |
Business Practice Address: | 400 Airport Rd Terrell, TX - 751604302 |
Business Phone Number: | 9725244159 |
Business Fax Number: | 9725634433 |
Mailing Address: | Po Box 747, TERRELL |
State: | TX |
Postal Code: | 751600014 |
Phone Number: | 9725244159 |
Fax Number: | 9725634433 |
NPI Enumeration Date: | 07/15/2014 |
NPI Last Update Date: | 07/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 69283 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |