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General NPI Number Information
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NPI Number | 1477923647
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Entity Type | Individual
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Provider Name | STEPHEN CHILTON
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Gender | Male
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 10/01/2015
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Provider Practice Location Address
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Address Line | 400 AIRPORT RD
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City | TERRELL
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State | TX
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Zip | 75160-4302
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Country | US
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Telephone | 972-524-4159
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Fax | 972-524-1002
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Provider Business Mailing Address
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Address Line | PO BOX 747
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City | TERRELL
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State | TX
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Zip | 75160-0014
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Country | US
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Telephone | 972-524-4159
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Fax | 972-524-1002
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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 | 4907
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License Number State | TX
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