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General NPI Number Information
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NPI Number | 1518374107
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Entity Type | Organization
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Legal Business Name | DLS GROUP LLC
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Dates
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Enumeration Date | 07/16/2014
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Last Update Date | 07/16/2014
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Provider Practice Location Address
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Address Line | 4011 W PLANO PKWY SUITE 104
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City | PLANO
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State | TX
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Zip | 75093-5629
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Country | US
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Telephone | 972-612-5615
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Fax |
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Provider Business Mailing Address
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Address Line | 4011 W PLANO PKWY SUITE 104
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City | PLANO
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State | TX
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Zip | 75093-5629
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Country | US
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Telephone | 972-612-5615
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | LAURIE GAINES
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Credential | M. ED, MA, LPC
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Telephone | 469-222-6712
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 68693
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License Number State | TX
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