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General NPI Number Information
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NPI Number | 1235314899
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Entity Type | Organization
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Legal Business Name | PSYCHOTHERAPY, TRAINING AND EDUCATION CENTER, INC.
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 7833 OAKMONT BLVD SUITE 110
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City | FORT WORTH
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State | TX
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Zip | 76132-4231
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Country | US
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Telephone | 817-665-0583
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Fax | 817-370-8977
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Provider Business Mailing Address
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Address Line | 7833 OAKMONT BLVD SUITE 110
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City | FORT WORTH
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State | TX
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Zip | 76132-4231
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Country | US
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Telephone | 817-665-0583
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Fax | 817-370-8977
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARY B ABLETT
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Credential | LCSW
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Telephone | 817-665-0583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 39014
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License Number State | TX
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