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General NPI Number Information
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NPI Number | 1457824310
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Entity Type | Organization
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Legal Business Name | DALLAS THERAPY GROUP PLLC
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Dates
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Enumeration Date | 01/03/2019
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 11551 FOREST CENTRAL DR STE 200
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City | DALLAS
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State | TX
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Zip | 75243-3966
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Country | US
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Telephone | 972-630-8889
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Fax |
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Provider Business Mailing Address
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Address Line | 15300 LOOKOUT POINT CIR
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City | FRISCO
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State | TX
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Zip | 75035-6649
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Country | US
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Telephone | 972-207-0457
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. NATALIE KINGSLEY
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Credential | DCLINPSYCH
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Telephone | 972-630-8889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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