Healthcare Provider Details

I. General information

NPI: 1053867515
Provider Name (Legal Business Name): CATHY ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 ADAMS DR
CRANDALL TX
75114-2401
US

IV. Provider business mailing address

711 ADAMS DR
CRANDALL TX
75114-2401
US

V. Phone/Fax

Practice location:
  • Phone: 214-587-7551
  • Fax:
Mailing address:
  • Phone: 214-587-7551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: