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NPI Code Detail

MEDICARE: MONYA CROW LPC

MEDICARE:   MONYA  CROW  LPC
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 Counselor60519TX

General Provider Information

NPI Number : 1184875742
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONYA CROW LPC
Provider Business Mailing Address
First Line : 4150 INTERNATIONAL PLZ
Second Line : SUITE 600
City : FORT WORTH
State : TX
Zip : 76109-4892
Country : US
Telephone Number : 817-349-4396
Fax Number :
Provider Business Practice Location Address
First Line : 4150 INTERNATIONAL PLZ
Second Line : SUITE 600
City : FORT WORTH
State : TX
Zip : 76109-4892
Country : US
Telephone Number : 817-349-4396
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2008
Last Update Date : 10/01/2008

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Directions to “ MONYA CROW LPC” Practice Location

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