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General NPI Number Information
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NPI Number | 1497400782
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Entity Type | Organization
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Legal Business Name | TEXAS A&M COMMERCE
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 510 HEARD STREET
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City | MCKINNEY
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State | TX
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Zip | 75069
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Country | US
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Telephone | 469-302-6318
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 3011
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City | COMMERCE
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State | TX
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Zip | 75429
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Country | US
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Telephone | 903-886-5637
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Fax | 903-886-5594
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | CANDACE CHUYOU-CAMPBELL
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Credential | PHD, LPC-S, RPT-S
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Telephone | 469-302-6318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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