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General NPI Number Information
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NPI Number | 1568969590
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Entity Type | Organization
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Legal Business Name | AWEN PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 04/06/2018
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Last Update Date | 04/06/2018
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Provider Practice Location Address
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Address Line | 3650 CEDARPLAZA LN APT 1128
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City | DALLAS
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State | TX
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Zip | 75209-6326
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Country | US
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Telephone | 281-793-6072
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Fax |
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Provider Business Mailing Address
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Address Line | 3650 CEDARPLAZA LN APT 1128
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City | DALLAS
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State | TX
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Zip | 75209-6326
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Country | US
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Telephone | 281-793-6072
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. THERRON PATRICK HUME
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Credential | PSY.D
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Telephone | 281-793-6072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 37280
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License Number State | TX
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