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General NPI Number Information
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NPI Number | 1356828396
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Entity Type | Individual
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Provider Name | TARYN ELIZABETH MAU MA, LMFT
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Gender | Female
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Dates
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Enumeration Date | 07/23/2018
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 6220 RICHMOND AVE
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City | DALLAS
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State | TX
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Zip | 75214-3636
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Country | US
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Telephone | 662-259-8224
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Fax |
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Provider Business Mailing Address
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Address Line | 6220 RICHMOND AVE
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City | DALLAS
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State | TX
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Zip | 75214-3636
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Country | US
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Telephone | 574-780-3559
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T0554
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 205132
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 35002017A
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License Number State | IN
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