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General NPI Number Information
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NPI Number | 1396788899
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Entity Type | Individual
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Provider Name | NANCY R BOX LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4255 BRYANT IRVIN RD SUITE 107
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City | FORT WORTH
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State | TX
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Zip | 76109-4233
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Country | US
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Telephone | 817-602-0554
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Fax | 775-459-0849
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Provider Business Mailing Address
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Address Line | 1937 CHATBURN CT
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City | FORT WORTH
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State | TX
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Zip | 76110-1210
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Country | US
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Telephone | 817-602-0554
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Fax | 775-459-0849
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12733
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License Number State | TX
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