Healthcare Provider Details

I. General information

NPI: 1194979096
Provider Name (Legal Business Name): MARTHA ELIZABETH BEBEE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2008
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2099 N COLLINS BLVD SUITE 100
RICHARDSON TX
75080-2698
US

IV. Provider business mailing address

2099 N COLLINS BLVD SUITE 100
RICHARDSON TX
75080-2698
US

V. Phone/Fax

Practice location:
  • Phone: 972-437-4698
  • Fax:
Mailing address:
  • Phone: 972-437-4698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number63688
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: