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General NPI Number Information
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NPI Number | 1063779239
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Entity Type | Organization
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Legal Business Name | SHAWN BOGGS COUNSELING, PLLC
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 601 S MAIN ST SUITE 212
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City | GRAPEVINE
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State | TX
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Zip | 76051-5382
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Country | US
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Telephone | 817-410-4772
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Fax | 817-410-4773
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Provider Business Mailing Address
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Address Line | 601 S MAIN ST SUITE 212
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City | GRAPEVINE
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State | TX
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Zip | 76051-5382
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Country | US
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Telephone | 817-410-4772
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Fax | 817-410-4773
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Authorized Official
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Title or Position | OWNER & OPERATOR
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Name | MR. SHAWN DEWAYNE BOGGS
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Credential | LMFT
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Telephone | 817-410-4772
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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 |
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License Number State |
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