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General NPI Number Information
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NPI Number | 1366082240
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Entity Type | Organization
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Legal Business Name | CARBERY CENTER FOR CHILD DEVELOPMENT PLLC
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Dates
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Enumeration Date | 01/08/2020
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 6060 N CENTRAL EXPY STE 222
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City | DALLAS
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State | TX
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Zip | 75206-5318
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Country | US
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Telephone | 214-766-9197
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 LEE PKWY APT 1904
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City | DALLAS
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State | TX
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Zip | 75219-5228
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Country | US
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Telephone | 214-766-9197
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE D CARBERY
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Credential | LPC
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Telephone | 214-766-9197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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