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General NPI Number Information
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NPI Number | 1235152257
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Entity Type | Individual
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Provider Name | CHARLOTTE MARIE TARELL LPC
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 10/30/2009
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Provider Practice Location Address
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Address Line | 2750 VIRGINIA PKWY STE 108
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City | MCKINNEY
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State | TX
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Zip | 75071-4970
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Country | US
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Telephone | 972-542-8144
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Fax |
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Provider Business Mailing Address
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Address Line | 915 SHOAL CREEK DR
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City | FAIRVIEW
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State | TX
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Zip | 75069-1950
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Country | US
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Telephone | 972-363-0654
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC 65419
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License Number State | TX
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