Healthcare Provider Details

I. General information

NPI: 1548680911
Provider Name (Legal Business Name): DAVID HUFFMAN PHD, LPC, RPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 04/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 WINDSOR CENTRE TRL SUITE 600
FLOWER MOUND TX
75028-1858
US

IV. Provider business mailing address

4320 WINDSOR CENTRE TRL SUITE 600
FLOWER MOUND TX
75028-1858
US

V. Phone/Fax

Practice location:
  • Phone: 972-432-6670
  • Fax: 972-996-2262
Mailing address:
  • Phone: 972-432-6670
  • Fax: 972-996-2262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number65236
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: