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NPI Code Detail

MEDICARE: MARY FALLER M.A., L.P.C.

MEDICARE:   MARY  FALLER  M.A., L.P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor69224TX

General Provider Information

NPI Number : 1033463609
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY FALLER M.A., L.P.C.
Provider Business Mailing Address
First Line : PO BOX 3545
Second Line :
City : COPPELL
State : TX
Zip : 75019-9545
Country : US
Telephone Number : 716-983-5322
Fax Number :
Provider Business Practice Location Address
First Line : 600 S DENTON TAP RD
Second Line :
City : COPPELL
State : TX
Zip : 75019-4533
Country : US
Telephone Number : 716-983-5322
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2012
Last Update Date : 11/05/2012

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Directions to “ MARY FALLER M.A., L.P.C.” Practice Location

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