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General NPI Number Information
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NPI Number | 1164988127
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Entity Type | Organization
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Legal Business Name | WADE FAMILY SERVICES PLLC
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Dates
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Enumeration Date | 02/14/2019
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Last Update Date | 02/14/2019
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Provider Practice Location Address
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Address Line | 1901 MEDI PARK DR SUITE 130
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City | AMARILLO
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State | TX
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Zip | 79106
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Country | US
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Telephone | 405-443-7303
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Fax | 806-553-6002
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Provider Business Mailing Address
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Address Line | 1901 MEDI PARK DR SUITE 130
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City | AMARILLO
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State | TX
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Zip | 79106
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Country | US
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Telephone | 405-443-7303
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Fax | 806-553-6002
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. ASHLEY NICHOLE WADE
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Credential | LPC
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Telephone | 405-443-7303
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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 |
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License Number State |
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