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General NPI Number Information
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NPI Number | 1013409077
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Entity Type | Organization
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Legal Business Name | MIRACLE PROFESSIONAL COUNSELING PLLC
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Dates
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Enumeration Date | 06/05/2018
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Last Update Date | 06/05/2018
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Provider Practice Location Address
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Address Line | 102 E MOORE AVE STE 214
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City | TERRELL
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State | TX
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Zip | 75160-3200
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Country | US
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Telephone | 972-953-8542
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Fax |
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Provider Business Mailing Address
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Address Line | 102 E MOORE AVE STE 214
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City | TERRELL
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State | TX
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Zip | 75160-3200
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Country | US
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Telephone | 972-953-8542
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Fax |
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Authorized Official
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Title or Position | MANAGING OWNER
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Name | DEBORAH MIRACLE
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Credential | LPC
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Telephone | 972-953-8542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 74127
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License Number State | TX
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