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General NPI Number Information
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NPI Number | 1518108414
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Entity Type | Organization
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Legal Business Name | COACH ABBY, INC. COUNSELING SERVICES
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Dates
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Enumeration Date | 03/23/2009
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Last Update Date | 03/23/2009
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Provider Practice Location Address
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Address Line | 10300 N CENTRAL EXPY SUITE 293
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City | DALLAS
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State | TX
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Zip | 75231-8600
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Country | US
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Telephone | 469-916-4200
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Fax | 214-943-2429
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Provider Business Mailing Address
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Address Line | 10300 N CENTRAL EXPY SUITE 293
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City | DALLAS
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State | TX
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Zip | 75231-8600
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Country | US
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Telephone | 469-916-4200
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Fax | 214-943-2429
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Authorized Official
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Title or Position | LICENSED COUNSELOR/ PRESIDENT
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Name | MRS. ROBBIE S REDMON
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Credential | M.ED., LPC
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Telephone | 469-916-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 62134
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License Number State | TX
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