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General NPI Number Information
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NPI Number | 1295148484
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Entity Type | Organization
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Legal Business Name | ORIGINAL INTENT COUNSELING CENTER
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Dates
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Enumeration Date | 06/05/2014
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Last Update Date | 06/05/2014
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Provider Practice Location Address
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Address Line | 400 N ALLEN DR STE 103
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City | ALLEN
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State | TX
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Zip | 75013-2555
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Country | US
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Telephone | 469-213-8624
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Fax | 469-519-0368
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Provider Business Mailing Address
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Address Line | 400 N ALLEN DR STE 103
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City | ALLEN
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State | TX
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Zip | 75013-2555
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Country | US
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Telephone | 469-213-8624
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Fax | 469-519-0368
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Authorized Official
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Title or Position | OWNER
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Name | ALLISON LAMBERT
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Credential | M.A., L.P.C.
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Telephone | 469-213-8624
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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 | 64418
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License Number State | TX
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