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General NPI Number Information
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NPI Number | 1174250427
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Entity Type | Individual
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Provider Name | MARY KINES LPC-ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 08/05/2022
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 215 N MOORE RD APT 1124
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City | COPPELL
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State | TX
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Zip | 75019-5285
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Country | US
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Telephone | 940-290-1916
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Fax |
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Provider Business Mailing Address
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Address Line | 215 N MOORE RD APT 1124
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City | COPPELL
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State | TX
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Zip | 75019-5285
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Country | US
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Telephone | 940-290-1916
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 95077
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License Number State | TX
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