Doctor Name: | TEX PREWITT |
NPI Number: | 1144469560 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 1090 S Vulture Mine Rd Wickenburg, AZ - 853903145 |
Business Phone Number: | 9286846600 |
Business Fax Number: | 9286846628 |
Mailing Address: | 40 W Yavapai St, WICKENBURG |
State: | AZ |
Postal Code: | 853903201 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/09/2009 |
NPI Last Update Date: | 02/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | School |
Taxonomy Definition: |