Healthcare Provider Details

I. General information

NPI: 1356551758
Provider Name (Legal Business Name): PATRICIA GERMANY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14114 DALLAS PKWY SUITE 245
DALLAS TX
75254-4325
US

IV. Provider business mailing address

14114 DALLAS PKWY SUITE 245
DALLAS TX
75254-4325
US

V. Phone/Fax

Practice location:
  • Phone: 972-774-9595
  • Fax: 972-429-5956
Mailing address:
  • Phone: 972-774-9595
  • Fax: 972-429-5956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11525
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: