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General NPI Number Information
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NPI Number | 1619138062
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Entity Type | Organization
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Legal Business Name | JOHNSON-HYDE CORP
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 275 W CAMPBELL RD SUITE 430
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City | RICHARDSON
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State | TX
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Zip | 75080-3601
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Country | US
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Telephone | 972-918-0170
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1171
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City | ADDISON
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State | TX
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Zip | 75001-1171
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Country | US
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Telephone | 972-918-0170
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | TAMMY HYDE
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Credential | LPC
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Telephone | 972-918-0170
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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 | 16623
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License Number State | TX
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