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General NPI Number Information
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NPI Number | 1487736682
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Entity Type | Organization
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Legal Business Name | DEYOUNG CONSULTING INC.
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 4928 PARK BROOK DR
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City | FORT WORTH
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State | TX
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Zip | 76137-5412
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Country | US
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Telephone | 817-988-8242
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Fax | 817-656-5544
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Provider Business Mailing Address
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Address Line | 4928 PARK BROOK DR
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City | FORT WORTH
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State | TX
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Zip | 76137-5412
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Country | US
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Telephone | 817-988-8242
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Fax | 817-656-5544
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH MARK DEYOUNG
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Credential | LMFT
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Telephone | 817-656-5544
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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 | 4796
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License Number State | TX
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