Healthcare Provider Details

I. General information

NPI: 1174714059
Provider Name (Legal Business Name): BARBARA ANN HEUSER M.S.W., LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA BROSS WALLACE M.S.W., LCSW

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 09/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 CUSTER ROAD
RICHARDSON TX
75080
US

IV. Provider business mailing address

320 CUSTER ROAD
RICHARDSON TX
75080
US

V. Phone/Fax

Practice location:
  • Phone: 972-490-9055
  • Fax: 972-265-0392
Mailing address:
  • Phone: 972-490-9055
  • Fax: 972-265-0392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29777
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: