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General NPI Number Information
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NPI Number | 1003562109
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Entity Type | Individual
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Provider Name | HEATHER LOVE
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Gender | Female
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Dates
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Enumeration Date | 02/28/2022
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 415 HIGHWAY 377 S STE 101
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City | ARGYLE
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State | TX
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Zip | 76226-5140
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Country | US
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Telephone | 940-222-8552
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Fax |
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Provider Business Mailing Address
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Address Line | 3704 SAMUEL CT
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City | FLOWER MOUND
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State | TX
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Zip | 75028-1630
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Country | US
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Telephone | 678-372-2643
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 203970
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License Number State | TX
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