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General NPI Number Information
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NPI Number | 1144629569
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Entity Type | Organization
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Legal Business Name | WIB NEWTON, PLLC
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 4211 W I 40 SUITE 203
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City | AMARILLO
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State | TX
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Zip | 79106-6053
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Country | US
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Telephone | 806-374-5950
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Fax | 806-358-4345
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Provider Business Mailing Address
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Address Line | 4211 W I 40 SUITE 203
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City | AMARILLO
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State | TX
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Zip | 79106-6053
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Country | US
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Telephone | 806-374-5950
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Fax | 806-358-4345
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MR. WILBERT J NEWTON
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Credential | LPC-S, LMFT
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Telephone | 806-374-5950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 14311
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License Number State | TX
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