Healthcare Provider Details

I. General information

NPI: 1649597543
Provider Name (Legal Business Name): PAYAL PUNATAR M.S., CRC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2010
Last Update Date: 05/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2419 COIT RD SUITE C
PLANO TX
75075-3731
US

IV. Provider business mailing address

2432 WINTERSTONE DR
PLANO TX
75023-7819
US

V. Phone/Fax

Practice location:
  • Phone: 972-836-7775
  • Fax:
Mailing address:
  • Phone: 972-836-7775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number62585
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number00096858
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: