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General NPI Number Information
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NPI Number | 1568196921
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Entity Type | Individual
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Provider Name | LA TRICIA CLEVELAND LMFT-A
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Gender | Female
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 4888 DEXTER DR # 300
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City | PLANO
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State | TX
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Zip | 75093-5505
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Country | US
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Telephone | 469-717-0662
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Fax |
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Provider Business Mailing Address
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Address Line | 4900 AIRPORT PKWY UNIT 401
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City | ADDISON
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State | TX
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Zip | 75001-3811
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Country | US
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Telephone | 214-850-6915
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Fax |
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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 | 204564
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License Number State | TX
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