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General NPI Number Information
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NPI Number | 1083940159
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Entity Type | Individual
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Provider Name | SARAH JANE FERGUSON LPC-INTERN
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Gender | Female
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | 4801 FRANKFORD RD SUITE 200
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City | DALLAS
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State | TX
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Zip | 75287-5330
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Country | US
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Telephone | 972-930-0260
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Fax |
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Provider Business Mailing Address
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Address Line | 8511 BACARDI DR
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City | DALLAS
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State | TX
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Zip | 75238-4923
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Country | US
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Telephone | 214-450-1023
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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 | 60569
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License Number State | TX
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