Healthcare Provider Details
I. General information
NPI: 1275847121
Provider Name (Legal Business Name): ARUSHA MALIK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/03/2010
Last Update Date: 04/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3920 ALMA DR LIFE PATH SYSTEMS
PLANO TX
75023-6748
US
IV. Provider business mailing address
3920 ALMA DR LIFE PATH SYSTEMS
PLANO TX
75023-6748
US
V. Phone/Fax
- Phone: 972-422-5939
- Fax:
- Phone: 972-422-5939
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 8481 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 68760 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: