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General NPI Number Information
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NPI Number | 1053849745
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Entity Type | Individual
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Provider Name | MARJORIE JO CHESEBRO LPC
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Gender | Female
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Dates
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Enumeration Date | 05/25/2017
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Last Update Date | 05/25/2017
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Provider Practice Location Address
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Address Line | 1001 CROSS TIMBERS RD STE 1240
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City | FLOWER MOUND
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State | TX
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Zip | 75028-8866
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Country | US
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Telephone | 972-966-1079
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Fax |
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Provider Business Mailing Address
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Address Line | 2011 COLORADO BLVD APT D
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City | DENTON
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State | TX
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Zip | 76205-7573
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Country | US
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Telephone |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 65873
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License Number State | TX
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