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NPI Code Detail

MEDICARE: MS. GLENDA JEAN FAULKNER-WOODLIFF LPC, LPC-S

MEDICARE: MS. GLENDA JEAN FAULKNER-WOODLIFF LPC, LPC-S
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 Counselor15239TX

General Provider Information

NPI Number : 1558418756
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GLENDA JEAN FAULKNER-WOODLIFF LPC, LPC-S
Provider Business Mailing Address
First Line : 7513 TEAKWOOD CT
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76182-7807
Country : US
Telephone Number : 817-479-3105
Fax Number : 847-565-8052
Provider Business Practice Location Address
First Line : 101 BOURLAND RD STE C
Second Line :
City : KELLER
State : TX
Zip : 76248-3507
Country : US
Telephone Number : 817-479-3105
Fax Number : 847-565-8052
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 01/31/2024

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